Tobias Luck - Academia.edu (original) (raw)

Papers by Tobias Luck

Hintergrund: Altern zu Hause ist vielen Menschen ein großes Bedürfnis. Die Ergebnisse internation... more Hintergrund: Altern zu Hause ist vielen Menschen ein großes Bedürfnis. Die Ergebnisse internationaler Einzelstudien sind nicht eindeutig, lassen aber vermuten, dass präventive Hausbesuche einen Vorteil in Bezug auf Mortalität und Heimübergang zeigen. Bislang liegen keine Daten[for full text, please go to the a.m. URL]

Neurobiology of Aging, 2016

Brain-derived neurotrophic factor (BDNF) has been discussed to be involved in plasticity processe... more Brain-derived neurotrophic factor (BDNF) has been discussed to be involved in plasticity processes in the human brain, in particular during aging. Recently, aging and its (neurodegenerative) diseases have increasingly been conceptualized as disconnection syndromes. Here, connectivity changes in neural networks (the connectome) are suggested to be the most relevant and characteristic features for such processes or diseases. To further elucidate the impact of aging on neural networks, we investigated the interaction between plasticity processes, brain connectivity, and healthy aging by measuring levels of serum BDNF and resting-state fMRI data in 25 young (mean age 24.8 ± 2.7 (SD) years) and 23 old healthy participants (mean age, 68.6 ± 4.1 years). To identify neural hubs most essentially related to serum BDNF, we applied graph theory approaches, namely the new data-driven and parameter-free approach eigenvector centrality (EC) mapping. The analysis revealed a positive correlation between serum BDNF and EC in the premotor and motor cortex in older participants in contrast to young volunteers, where we did not detect any association. This positive relationship between serum BDNF and EC appears to be specific for older adults. Our results might indicate that the amount of physical activity and learning capacities, leading to higher BDNF levels, increases brain connectivity in (pre)motor areas in healthy aging in agreement with rodent animal studies. Pilot results have to be replicated in a larger sample including behavioral data to disentangle the cause for the relationship between BDNF levels and connectivity.

Neurology, Jan 26, 2015

The aim of the present study was to investigate how different mentally demanding work conditions ... more The aim of the present study was to investigate how different mentally demanding work conditions during the professional life-i.e., enriched environments at work-might influence the rate of cognitive decline in old age. Individuals (n = 1,054) of the Leipzig Longitudinal Study of the Aged, a representative population-based cohort study of individuals aged 75 years and older, underwent cognitive testing via the Mini-Mental State Examination (MMSE) in up to 6 measurement waves. Type and level of mentally demanding work conditions in the participants' former professional life were classified based on the O*NET job descriptor database. In multivariate mixed-model analyses (controlling for sociodemographic and health-related factors), a high level of mentally demanding work tasks stimulating verbal intelligence was significantly associated with a better cognitive functioning at baseline (on average 5 MMSE points higher) as well as a lower rate of cognitive decline (on average 2 MMSE ...

Public Health Forum, 2012

SummaryDementia is common and one of the most burdensome diseases for sufferers and their relativ... more SummaryDementia is common and one of the most burdensome diseases for sufferers and their relatives; it is also one of the biggest challenges for the healthcare systems of aging societies. Professional nursing care and informal care by family or friends constitute the most significant cost components of dementia. In the absence of effective therapeutic options, a healthy lifestyle might be the best option to reduce the individual risk of developing dementia.

Acta psychiatrica Scandinavica, 2015

In this study, we aimed to analyze the association between new-incident-subjective memory complai... more In this study, we aimed to analyze the association between new-incident-subjective memory complaints (SMC) and risk of subsequent dementia in a general population sample aged 75+ years. Data were derived from follow-up (FUP) waves I-V of the population-based Leipzig Longitudinal Study of the Aged (LEILA75+). We used the Kaplan-Meier survival method to estimate dementia-free survival times of individuals with and without incident SMC and multivariable Cox proportional hazards regression to assess the association between incident SMC and risk of subsequent dementia, controlled for covariates. Of 443 non-demented individuals, 58 (13.1%) developed dementia during a subsequent 5.4-year follow-up period. Participants with incident SMC showed a significantly higher progression to dementia (18.5% vs. 10.0%; P = 0.010) and a significantly shorter mean dementia-free survival time than those without (6.2 vs. 6.8 years; P = 0.008). The association between incident SMC and risk of subsequent dem...

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2012

There is an increasing call for a stronger consideration of impairment in instrumental activities... more There is an increasing call for a stronger consideration of impairment in instrumental activities of daily living (IADL) in the diagnostic criteria of Mild Cognitive Impairment (MCI) to improve the prediction of dementia. Thus, the aim of the study was to determine the predictive capability of MCI and IADL impairment for incident dementia. Longitudinal cohort study with four assessments at 1.5-year intervals over a period of 4.5 years. : Primary care medical record registry sample. As part of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients, a sample of 3,327 patients from general practitioners, aged 75 years and older, was assessed. The predictive capability of MCI and IADL impairment for incident dementia was analysed using receiver operating characteristics, Kaplan-Meier survival analyses, and Cox proportional hazards models. MCI and IADL impairment were found to be significantly associated with higher conversion to, shorter time to, and better predict...

Obesity (Silver Spring, Md.), 2015

Research consistently shows a negative view of individuals with obesity in the general public and... more Research consistently shows a negative view of individuals with obesity in the general public and in various other settings. Stigma and discrimination can be considered chronic stressors, as these factors have a profound impact on the psychological well-being of the affected individuals. This article proposes a framework that entails a mediation of the adverse effects of discrimination and stigmatization on mental well-being through elevated psychological risk factors that are not unique to weight but that could affect overweight and normal-weight individuals alike. A systematic review was conducted to assess the prevalence of psychological risk factors, such as self-esteem and coping, in individuals with obesity. Forty-six articles were assessed and included for detailed analysis. The number of studies on these topics is limited to certain dimensions of psychological processes. The best evaluated association of obesity and psychosocial aspects is seen for self-esteem. Most studies ...

Journal of geriatric psychiatry and neurology, Jan 26, 2014

This study investigates the impact of occupation-based motivational processes and social network ... more This study investigates the impact of occupation-based motivational processes and social network variables on the incidence of dementia over 8 years. Data were derived from the Leipzig Longitudinal Study of the Aged (LEILA75+), a population-based longitudinal study of individuals aged 75 years and older (n = 1692 at baseline). Motivational processes were estimated based on the main occupation using the Occupational Information Network database. In a Cox proportional hazard model, motivational processes were not associated with the risk of dementia (hazard ratio [HR]: 0.93, 95% confidence interval [CI]: 0.74-1.16). Individuals with a higher frequency of social contact at baseline had a significantly lower risk of dementia (HR: 0.96, 95% CI: 0.91-0.99), while proximity of social contacts was not linked to the risk of dementia (HR: 1.03, 95% CI: 0.98-1.08). In individuals with low indices of motivational processes, the frequency of social contacts was associated with a lower risk of de...

Social Psychiatry and Psychiatric Epidemiology, 2010

In the last decades, many community-based studies have addressed predictors of nursing home place... more In the last decades, many community-based studies have addressed predictors of nursing home placement (NHP) among the elderly. So far, predictors have not been analyzed separately for different age groups. For a German GP-sample of 3,208 subjects aged 75 years and older, socio-demographic, clinical, and psychometric parameters were requested every 1.5 years over three waves. Logistic regression models determined predictors of NHP for total sample and for two different age groups. A CART analysis identified factors discriminating best between institutionalized and non-institutionalized individuals. Of the overall sample, 4.7% of the sample (n = 150) was institutionalized during the study period. Baseline characteristics associated with a higher risk of NHP for the total sample were age, living without spouse, cognitive and functional impairment and depression. In the CART analysis, age was the major discriminator at the first level (at age 81). In subgroup regression analyses, for the younger elderly (age 75-81) being single as well as cognitive and functional impairment increased the risk of NHP; in the advanced elderly (age 82+) being widowed and subjective memory impairment were significant predictors for NHP, and cognitive and functional impairment became non-significant as predictors of NHP. Predictors of NHP may differ in old age groups. The fact that many predictors show inconsistent results as predictors of NHP in the international literature may be attributed to the lack of differentiation in age groups.

Psychological Medicine, 2007

BackgroundThe association of subjective memory impairment (SMI) with cognitive performance in hea... more BackgroundThe association of subjective memory impairment (SMI) with cognitive performance in healthy elderly subjects is poor because of confounds such as depression. However, SMI is also a predictor for future dementia. Thus, there is a need to identify subtypes of SMI that are particularly related to inferior memory performance and may represent at-risk stages for cognitive decline.MethodA total of 2389 unimpaired subjects were recruited from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe), as part of the German Competence Network on Dementia. Clusters of SMI according to patterns of response to SMI questions were identified. Gender, age, depressive symptoms, apolipoprotein E (apoE) genotype, delayed recall and verbal fluency were included in a Classification and Regression Tree (CART) analysis to identify discriminators between the clusters.ResultsWe identified three clusters. Cluster 1 contained subjects without memory complaints. Cluster 2...

PLoS ONE, 2013

Aims: The aim of the study was to investigate the impact of depression (categorical diagnosis; ma... more Aims: The aim of the study was to investigate the impact of depression (categorical diagnosis; major depression, MD) and depressive symptoms (dimensional diagnosis and symptom patterns) on incident dementia in the German general population. Methods: Within the Leipzig Longitudinal Study of the Aged (LEILA 75+), a representative sample of 1,265 individuals aged 75 years and older were interviewed every 1.5 years over 8 years (mean observation time 4.3 years; mean number of visits 4.2). Cox proportional hazards and binary logistic regressions were used to estimate the effect of baseline depression and depressive symptoms on incident dementia. Results: The incidence of dementia was 48 per 1,000 person-years (95% confidence interval (CI) 45-51). Depressive symptoms (Hazard ratio HR 1.03, 95% CI 1.01-1.05), and in particular mood-related symptoms (HR 1.08, 95% CI 1.03-1.14), showed a significant impact on the incidence of dementia only in univariate analysis, but not after adjustment for cognitive and functional impairment. MD showed only a significant impact on incidence of dementia in Cox proportional hazards regression, but not in binary logistic regression models. Discussion: The present study using different diagnostic measures of depression on future dementia found no clear significant associations of depression and incident dementia. Further in-depth investigation would help to understand the nature of depression in the context of incident dementia.

Journal of Affective Disorders, 2012

International Psychogeriatrics, 2009

Background: This study examines the effectiveness of a nursing home staff training program design... more Background: This study examines the effectiveness of a nursing home staff training program designed to improve the interaction between residents with dementia and their caregivers. Methods: A three-arm cluster-randomized and controlled population of 96 caregivers and 210 residents was used. Caregivers of the intervention group (IG) received a three-month training program in dementia care. Data were gathered at baseline, immediately after the training and at a six-month follow-up-assessment. Shortand long-term effects of the training program were assessed in comparison with another intervention referred to as the relaxation group (RG) and a wait-list control group (CG). Results: Results indicated significant positive effects of the training program on caregivers' knowledge immediately after the training and on the use of physical restraints at the six-month follow-up. Caregivers' overall competence increased significantly both in the IG and in the RG. No intervention effects were found on caregivers' level of burnout, their health complaints or on the use of sedative drugs. Relaxation training was more successful in the reduction of caregivers' health complaints. Conclusions: Results of the study indicate both the effectiveness and the limitations of a general training program in dementia care. The complexity of the nursing home setting potentially needs more complex interventions. Ongoing and continued support of the caregivers, as well as changes in organization and environment, are more likely to be helpful in the long-term improvement in the quality of care. Future research should focus on studies of specific interventions, such as the interesting effects of relaxation training on the caregivers' state of health.

Das Gesundheitswesen, 2010

Background. Early diagnosis of dementia requires knowledge about associated predictors. The aim o... more Background. Early diagnosis of dementia requires knowledge about associated predictors. The aim of this study was to determine the impact of mild cognitive impairment (MCI) and impairment in instrumental activities of daily living (IADL) on the time to an incident dementia diagnosis. Method. Data were derived from the Leipzig Longitudinal Study of the Aged (LEILA75+), a population-based study of individuals aged o75 years. Kaplan-Meier survival analysis was used to determine time to incident dementia. Cox proportional hazards models were applied to determine the impact of MCI and IADL impairment on the time to incident dementia. Results. In total, 180 (22.0 %) of 819 initially dementia-free subjects developed dementia by the end of the study. Mean time to incident dementia was 6.7 years [95 % confidence interval (CI) 6.5-6.9]. MCI combined with IADL impairment was associated with a higher conversion rate to dementia, a shorter time to clinically manifest diagnosis and a lower chance of reversibility to cognitive normal. The highest risk for a shorter time to incident dementia was found for amnestic MCI combined with IADL impairment. The mean time to incident dementia was 3.7 years (95 % CI 2.9-4.4) and thus half as long as in subjects without MCI and IADL impairment. Conclusions. Subjects with MCI and IADL impairment constitute a high-risk population for future dementia. The consideration of both-MCI and IADL impairment-might help to improve the prediction of dementia.

Das Gesundheitswesen, 2011

Das Gesundheitswesen, 2009

Background/aims Little is known about the direct costs of individuals with Mild Cognitive Impairm... more Background/aims Little is known about the direct costs of individuals with Mild Cognitive Impairment (MCI). This study investigates the direct costs associated with MCI according to recent diagnostic criteria from a societal perspective. Methods Four hundred and fifty-two primary care patients aged 75þ from Leipzig, Germany, were investigated in face-to-face interviews regarding MCI according to the current diagnostic criteria of the International Working Group on MCI, resource utilisation and costs (questionnaire of service utilisation and costs), as well as chronic medical illness (Chronic Disease Score). Resource utilisation was monetarily valued using 2004/2005 prices. Results Mean annual direct costs were s4,443 for patients with MCI (n ¼ 39) and s3,814 for patients without MCI (n ¼ 413) (p ¼ 0.34). Looking at the cost components, patients with and without MCI only significantly differed regarding pharmaceutical costs (s 1,210 vs s 1,062; p < 0.05) not caused by antidementive drugs. Conclusion Direct costs of individuals having MCI are not significantly increased in comparison to direct costs of individuals without cognitive deficits.

Zeitschrift für Gerontopsychologie & -psychiatrie, 2007

Zusammenfassung: Mit dem SIDAM (Strukturiertes Interview für die Diagnose einer Demenz vom Alzhei... more Zusammenfassung: Mit dem SIDAM (Strukturiertes Interview für die Diagnose einer Demenz vom Alzheimer Typ, der Multiinfarkt- Demenz und Demenzen anderer Ätiologie nach DSM-III-R, DSM-IV und ICD-10) liegt ein standardisiertes Interview vor, welches Screening und Diagnose von Demenzen und leichten kognitiven Beeinträchtigungen ermöglicht. Alters- und bildungsspezifische Normen für den kognitiven Leistungsteil sind dabei unerlässlich, ihrerseits jedoch stark von der zugrunde liegenden Bildungsklassifikation abhängig. In der vorliegenden Arbeit werden bevölkerungsrepräsentative alters- und bildungsspezifische Normen des kognitiven SIDAM-Leistungsteiles auf der Grundlage einer aktuellen, nachvollziehbaren und international anerkannten Bildungsklassifikation (newCASMIN; Brauns & Steinmann, 1999 ) vorgelegt. Für die Trennung dementer von nichtdementen Personen werden Cut-off-Werte des SIDAM-Gesamtscores vorgeschlagen. Ermittelte statistische Kennwerte der einzelnen SIDAM-Subskalen ermöglich...